Geographic variation in poststroke depression among veterans with acute stroke

Huanguang Jia, L. Douglas Ried, Xinping Wang, Teresa Damush, Linda J. Young, Randi H. Cameon, Linda Williams

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

This study compared patterns of poststroke depression (PSD) detection among veterans with acute stroke in eight U.S. geographic regions. Department of Veterans Affairs (VA) medical and pharmacy data as well as Medicare data were used. International Classification of Diseases-9th Revision depression codes and antidepressant medication dispensing were applied to define patients' PSD status 12 months post-stroke. Logistic regression models were fit to compare VA PSD diagnosis and overall PSD detection between the regions. The use of VA medical data alone may underestimate the rate of PSD. Geographic variation in PSD detection depended on the data used. If VA medical data alone were used, we found no significant variation. If VA medical data were used along with Medicare and VA pharmacy data, we observed a significant variation in overall PSD detection across the regions after adjusting for potential risk factors. VA clinicians and policy makers need to consider enrollees' use of services outside the system when conducting program evaluation. Future research on PSD among veteran patients should use VA medical data in combination with Medicare and VA pharmacy data to obtain a comprehensive understanding of patients' PSD.

Original languageEnglish
Pages (from-to)1027-1036
Number of pages10
JournalJournal of Rehabilitation Research and Development
Volume45
Issue number7
DOIs
StatePublished - 2008

Fingerprint

Veterans
Stroke
Medicare
Logistic Models
Program Evaluation
International Classification of Diseases
Administrative Personnel
Antidepressive Agents

Keywords

  • "Stroke belt,"
  • Geographic variation
  • ICD-9
  • Medicare
  • Poststroke depression
  • PSD detection
  • Rehabilitation
  • Stroke
  • VA
  • Veterans

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Geographic variation in poststroke depression among veterans with acute stroke. / Jia, Huanguang; Ried, L. Douglas; Wang, Xinping; Damush, Teresa; Young, Linda J.; Cameon, Randi H.; Williams, Linda.

In: Journal of Rehabilitation Research and Development, Vol. 45, No. 7, 2008, p. 1027-1036.

Research output: Contribution to journalArticle

Jia, Huanguang ; Ried, L. Douglas ; Wang, Xinping ; Damush, Teresa ; Young, Linda J. ; Cameon, Randi H. ; Williams, Linda. / Geographic variation in poststroke depression among veterans with acute stroke. In: Journal of Rehabilitation Research and Development. 2008 ; Vol. 45, No. 7. pp. 1027-1036.
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